Organization Active NPI

Muscatine Chiropractic Center PC

  • Chiropractor
  • Muscatine, IA
National Provider Identifier
1447398607
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05523 Issued in IA
Legal business name
MUSCATINE CHIROPRACTIC CENTER PC
Practice address
2209 2ND Ave
Muscatine, IA 52761-5258
Phone
(563) 264-8825
Fax
(563) 264-0869
NPI assigned
Feb 1, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Leo Elgatian, D.C.NPI 1598743528
Title
President
Phone
(563) 264-8825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X A05523 IA Primary

Addresses

Primary practice location

2209 2ND Ave
Muscatine, IA 52761-5258

Mailing address

2209 2ND Ave
Muscatine, IA 52761-5258
Phone (563) 264-8825

Other identifiers 1

IdentifierTypeStateIssuer
1069583MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070217000064 IA Part B Supplier - Clinic/Group Practice 8820190192 Receives reassigned benefits from 3 practitioners
Practice locations: Muscatine, IA

National Provider Directory

National Provider Directory

Locations

2209 2nd Ave
Muscatine, IA 52761
Phone (563) 264-8825

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447398607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 2ND AVE",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527615258",
            "telephone_number": "563-264-8825",
            "fax_number": "563-264-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 2ND AVE",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527615258",
            "telephone_number": "563-264-8825",
            "fax_number": "563-264-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSCATINE CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELGATIAN",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-264-8825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1069583",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muscatine, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.